Brain tumor : Diagnosis and Management

Brain tumor : Diagnosis and Management

Brain tumour is an abnormal or uncontrolled growth of cells found in the brain. In a healthy human body, normal cells grow old or die and new cells take their place. Sometimes, this process goes wrong. Some unnecessary new cells are produced when the body doesn’t need them, and old or damaged cells don’t die as they should. The formation of these extra cells often forms a mass of tissue called a growth or tumour. There are two main types of tumours which are called benign tumours (harmless growth) and malignant (cancerous tumours).

Brain tumour is a deadly disease. However, it can be treated by various methods but majority of patients die within 9-12 months and less than 3% survive more than 3 years.

Cancerous tumours can be divided into primary brain tumours that start within the brain, and secondary brain tumours that originate from somewhere else, but spread throughout the body, known as brain metastasis tumours.

There are many types of primary brain tumours. They are named according to the type of cells or the part of the brain in which they are found or begin. For example, if the brain tumour begins in glial cells it is called glioma. Similarly there are other types depending upon the part of brain in which the tumour originates.

Symptoms

The most common symptoms of brain tumour are:

Headache (usually worse in the morning)

Nausea and vomiting

Changes in speech, vision, or hearing

Problems in balancing or walking

Changes in mood, personality, or ability to concentrate

Problems with memory

Muscle jerking or twitching (seizures or convulsions)

Numbness or tingling in the arms or legs

Abnormal fatigue and weariness

Symptoms of tumour are associated with the position they present.

Each part of our brain control particular function , so a tumour can affect a specific area of the brain, thereby affecting its normal function . Some of the symptoms, according to their position, are as follows:

Brain stem:

Lack of co-ordination when walking

Double vision

Difficulty in swallowing and speaking

Facial weakness – one-sided smile

Eyelid weakness – Difficulty in closing eye

Cerebellum:

Flickering, involuntary movement of the eyes

Vomiting and stiffness of the neck

Uncoordinated walking and speech

Temporal lobe:

Speech difficulties and memory problems.

Strange sensations – fear, blackouts, strange smells

Occipital lobe:

Gradual loss of vision on one side

Parietal lobe:

Problems with reading, writing or simple calculations

Difficulty in navigating one’s way around

Numbness or weakness in one side of the body

Difficulty in understanding words or speaking

Frontal lobe:

Unsteadiness and weakness on one side of body

Changes in personality

Loss of smell

Causes

There is no specific cause of brain tumour. Mutation of certain genes is thought to be the main cause of some types of tumour. The role of radiation caused by gadgets like mobile phones in causing various types of cancers including brain tumour is widely debated. However, this fact has not yet been proven. Research into this field is ongoing. Brain tumours, like other tumours, are not infectious and can’t be passed on to other people.

Diagnosis

Based on history, symptoms, physical and neurological examination, techniques like MRI, CT scan, angiogram or spinal tap may assist in diagnosis.

Neurologic exam: It includes testing of vision, hearing, alertness, muscle strength, coordination, and reflexes. Eyes are looked for swelling, caused by a tumour pressing on the nerve that connects the eye and the brain.

Angiogram: It is an imaging technique in which dye is injected into the bloodstream. If a tumour is present, the image may show the tumour or blood vessels that are feeding into the tumour.

Spinal tap: For diagnosis, sample of cerebrospinal fluid (the fluid that fills the spaces in and around the brain and spinal cord) is usually collected by a technique called lumbar puncture. For this process, a long, thin needle is used to remove fluid and it takes about 30 minutes.

MRI and CT scan are very useful imaging techniques in the diagnosis of brain tumour

Management

The treatment of brain tumour depends upon the type, grade, and position of tumour and general health of patient.

Some treatment options for brain tumours are as follows:-

Surgery: Surgery is usually the first step in the treatment of both benign and primary malignant brain tumours. This is performed on patient to remove maximum tumour so as to maintain neurological function.

Radiotherapy: High energy beams of radiation focus on cancerous tissue to stops them from multiplying.

Chemotherapy: Chemotherapy is a treatment where anti-cancer drugs are used to kill cancer cells, or to stop them from multiplying.

Steroids: Steroids are commonly used for reduction and prevention of inflammation around a brain tumour.

Anti-seizure medication: This is recommended for patients suffering from seizures.

Ventriculoperitoneal shunt (Also called a VP shunt): A VP shunt may be placed in the head to drain excess fluid from inside the brain thereby helping to control the pressure.

Encourage supportive care: Encourage supportive care for the patients suffering from brain tumour such as physical therapy, spiritual care and counselling to improve the quality of life